Core Swabs From Nasal Polyps- Bacterial Involvement? - An Eastern Indian Scenario

Nasal polyps are benign lesions commonly affecting up to 4% of the population [1]. Some theories considered polyps a consequence of conditions which cause chronic inflammation in the nose and nasal sinuses characterised by stromal oedema and cellular infiltration [2]. While many aspects of nasal polyps had been documented, the initiating cause remained unknown and might be different for different cases. Bernstein et al 2005 [3] showed the influence of inflammation of nasal mucosa on the growth of nasal polyps. Bacterial and viral infections produced factors which damaged ciliated cells, causing dyskinesis and destruction of respiratory epithelium. Disturbed muco-ciliary clearance permitted bacteria to penetrate through mucosa facilitating their adhesion and colonisation leading to inflammation [4]. The microbiology of chronic maxillary sinusitis was found to be polymicrobial [7-11], but there was dearth of data on bacterial pathogenesis of nasal polyps involving the Indian population. The present study was aimed to identify the resident (control setup) and pathological (patients diagnosed with nasal polyps) bacterial flora; and establish empirical antibiotic policy in nasal polyp. It further proposed to establish whether bacteria were the etiological factor in the development of nasal polyp. patients with nasal polyp of age-group 6-60yrs, irrespective of sex, undergoing polypectomy by Functional Endoscopic Sinus Surgery were labelled as 'cases'. The diagnosis of the sinus disease was based on history, clinical examination and CT scan. None of the subjects were on any oral/nasal corticosteroids or antibiotics for 3 Background: Nasal polyps are benign lesions of the nasal sinuses/cavity which develop in patients with disturbed local homoeostasis of nasal mucosa. Aim: To identify the resident (control setup) and pathological (patients diagnosed with nasal polyps) bacterial flora; and establish empirical antibiotic policy to treat nasal polyp. Methods: This prospective study involving 105 patients with nasal polyp as " cases " and 105 healthy subjects as " controls " was conducted at Medical College, Kolkata to assess the involvement of bacteria in polyp formation. Post polypectomy core swabs were processed for isolation of aerobic and anaerobic bacteria and antibiotic sensitivity performed thereafter. Results: Polyp tissue core swabs from nasal polyp cases revealed 94.3% culture-positive specimens (p<0.05) with 99 aerobic and 129 anaerobic isolates. The predominant aerobes were S. Levofloxacin showed an impressive overall 94.9% activity with 37 out of 39 gram negative and 57 out of 60 gram positive isolates being sensitive to it. Conclusion: This study illustrated the presence of polymicrobial aerobic-anaerobic bacteria …